The Way to Wellville — Spotlight: Health Q&A with Esther Dyson

Jun 26, 2014, 2:44 PM

At this week’s Spotlight: Health conference, an expansion this year of the annual Aspen Ideas Festival, angel investor Esther Dyson will be talking about “The Way to Wellville,” a contest that her nonprofit Health Initiative Coordinating Council—or “HICCup”—is organizing to encourage a rethinking of how communities produce health. The Way to Wellville is a five-year national competition among five communities to see which can make the greatest improvements in five measures of health and economic vitality.

“In the end, we hope to show that the best way to produce health is to change multiple interacting factors—diet, physical activity, preventive measures, smoking and the like—as well as more effective traditional health care,” said Dyson. “We’re less concerned with specific ‘innovations’ or digital miracles and more with simply applying what we already know at critical density.”

Esther Dyson, HICCup

The five health measures have not been finalized yet, but are likely to include health impact, financial impact, social/environmental impact (such as crime rate or high school graduation rate), sustainability (such as a health financing system) and a specific “wild card” that each community will set for itself, such as teenage pregnancy or smoking rates.

NewPublicHealth spoke with Dyson ahead of the Spotlight: Health conference about the Wellville contest.

NewPublicHealth: How did the contest come about?

Esther Dyson: I had signed up to be a judge on the Health Care X Prize, but unfortunately it never materialized. For the next few years I kept thinking somebody should do this, and as I got more and more interested in health, I thought that with greater and greater enthusiasm. I had to give some remarks at a quantified self conference last year and was going to say that “someone should do this.” But I realized that would be a very lame talk and ultimately I announced that I would do it. Having appointed myself, I arranged several open-call brainstorming sessions. At one of them, a nice gentleman showed up with lots of awkward questions about metrics, funding, evaluation...the usual! So I appointed him as CEO. That’s Rick Brush, who formerly worked at Cigna and more recently has been running asthma-prevention programs with innovative financial models.

The contest will be among five self-contained communities under 100,000 people each. I chose that number to hold down the resources and social capital needed, and also because it can be easier to gather data. For example, the residents don’t typically go elsewhere to work or eat or shop, which means that when you look at their aggregate grocery and restaurant data, you have a pretty good idea of what people are eating.

NPH: How many communities applied?

Dyson: We got 41 valid applications, which is about twice what we were expecting and we’re trying to winnow it down to five. At this point, we’ve got a short list of about 16 and we also feel somewhat like a school that can take only five children and there are 41 qualified kids. So we’re going to create Greater Wellville for all 41, as well as the contest of five. That’s going to be something like a network for the communities to learn from each other, and also a place where vendors, investors or philanthropists can go to find customers or partners—“Here are 41 communities where the people have already gathered to try and create greater health.”

The goal here is to generate both data and inspiration. The premise we’re testing is not that this or that program is better, but that combining a whole lot of things—such as changing the food supply, changing the walking environment, changing what the employers do—if you do them all together, each of them is going to be more effective.

NPH: Do you think that you will find some midpoint data that will be valuable?

Dyson: We hope that long before the five years is up, companies, foundations, nonprofits and others will come in and help the communities organize things such as healthy heart challenges and steps-walked contests and generate subsidiary data sets—and, we hope, even more excitement. The idea is for each community to build a framework for these programs to interact. A lot of it’s going to be changing the food supply rather than going in there and telling people this is what you should be eating. Just make the healthy food more accessible and perhaps cheaper, for example. We hope to work with a variety of food vendors who want test markets for their healthy options.

NPH: What do you think accounts for the strong response to the contest?

Dyson: I think partly we were lucky that the people we talked to—population health researchers, foundations, vendors, journalists, health care providers and payers—helped us reach other people, and partly a lot of this is in the air. Communities want to do something, but they’re short of resources. What we’re promising is not a whole bunch of money, but a lot of help in figuring out how to get money, who to talk to, where to go for ideas, for examples, how to share ideas and contacts with other communities like theirs.

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